To Squat or Not to Squat

When looking for an exercise that increases strength, incorporates a long list of muscles, and causes a large metabolic response, look no further than the squat.  Now when I mention “squat” most of you are thinking:

  • My doctor told me not to.
  • I don't want to use that part of the gym.
  • I'm intimidated by free weights.
  • What happens if I can't get back up?

Squats have gotten a bad rep over the years.  I’ve now heard from a wide variety of people including practitioners (Orthos, PTs, Chiros, etc.) that “squats are bad for the knees and / or back”.  My response is, “They can be, but they don’t have to be.” 

We all squat… all day long.  Do you get in and out of a chair?  Do you pick things up from the floor?  Do you get on and off of the commode?  If so, you are squatting.  Squats are an essential part of human movement.  Having the ability to squat effectively and efficiently MAKES LIFE EASIER.  Why wouldn’t you want to make life easier?

I’d say 1-5% of the general public have contraindications that should keep them from squatting consistently.  For the other 95-99% of us, we shouldn’t be asking whether I should or shouldn’t but “HOW SHOULD I?” What determines whether your squat is helping or hurting you is not how many reps, or in what setting (barbell, goblet, front/back, single leg, DB, etc.), or how frequent, it is the technique used when squatting.  

Poor squats can cause: 

  • Bulging disks in lumbar spine
  • Patella-Femoral Syndrome
  • Hip labrum fraying/tears
  • Patellar tendonitis

Squats completed with proper technique can improve:

  • Bone mineral density in pelvis, spine, and lower extremities
  • Core stabilization
  • Efficiency of ADL’s (activities of daily living)
  • Vertical jump
  • Sprint speed
  • Running efficiency
  • Deceleration
  • Change of direction
  • Rotational sport efficiency and power (throwing a baseball, golf swing, lacrosse shot, etc.)

It should be pretty clear by now that squats are one of if not THE most important exercise in your regimen.  Now, let’s focus on the “how”.  For today’s post, I’ll be explaining how to get your lower extremities set up properly for a bilateral (double leg) squat.  I will focus on the back and upper extremity positioning for other variations in a future post.

Alignment

Proper lower extremity alignment for most of the population can be achieve by keeping your patella (kneecap) and 3rd toe on the same line or plane of motion.  As you bend your ankle, knee, and hip joints during a squat, the three points mentioned should all stay in plane.  To determine this, find your pelvic crest on both sides of your hips.  Trace it forward until you feel a bony point in the front of your hips, slightly below your pant line.  This landmark, which we’ll abbreviate as ASIS makes up the beginning of the hip-knee-toe line.  Look in a mirror with your feet hip width and pointed straight forward to determine your standing position.  If you see your knees sitting inside the line between hip and toe, lift the arches of your feet up to bring knees outward (away from midline).  In the picture, you see hip-knee-second toe alignment with a hip width stance and toes straight forward.  This is optimal alignment but not necessarily the optimal squat stance.

 

Stance and Hip Angle

For optimal squat depth, we need to open our stance up from hip width to shoulder width.  This gives our hip sockets “room” to work until end range impingement occurs.  The optimal stance width is roughly shoulder width.  If you take your feet to shoulder width and keep them pointed forward, as you see in this pic, your hips wind up in internal rotation.  This position can damage the hip labrum and causes early impingement in your squat range. 

Based on the hip socket (acetabulum), “ball” of joint (femoral head) and femoral neck, the optimal squat depth can be achieved with your hip-knee-toe line externally rotated.  If you were standing on a clock with 12 o’clock in front of you, your feet should be pointed at 11 & 1 to 10 & 2.  Make sure that the knees stay out with the toe angle or you will fall into a position that causes joint problems and pain.  From top to bottom, the pictures to the right show:

  • Proper width but improper angle of foot placement
DSC01350.JPG
  • Proper width and angle of feet but knees adducting or turning inside optimal alignment
  • Proper width, angle of feet, and alignment

 

Try out your new squat stance next time you are in the gym or using the motion to sit down and get up from a chair.  You should feel your range of motion increase and pain decrease.

 

Happy Squatting!

 

Ryan Morrissey